Nominating a medical compliance officer within a private healthcare business

By Jamie Frew on Jan 4, 2022.

Overview on healthcare compliance

Working in the healthcare industry, you have probably heard the term compliance thrown around a lot. But you may be wondering what it exactly means. Healthcare compliance refers to the adherence to a set of rules and regulations pertaining to how healthcare professionals should interact with patients and handle sensitive data. Compliance standards are generated by federal and state law, in addition to the internal policies adopted by individual healthcare practices. Knowing how compliance regulations impact the way that you work is a critical aspect of working as a healthcare practitioner. Failure to comply can lead to various consequences, including patient mistrust, a damaged reputation, fines, and in serious situations, a loss of license.

Medical compliance and security are based around the notion that patient safety is just as important as patient care, and given the amount of sensitive information that is generated within the healthcare process, it is critical that you know the right way to handle it. Most healthcare businesses have internal compliance officers that manage training programs and are responsible for any investigations or raised concerns. The exact role of a compliance officer will depend upon the specific services offered by a practice, but essentially, they are responsible for ensuring the business is operating legally and ethically, and adhering to all necessary regulations.

Who is responsible for healthcare compliance in health systems?

In healthcare, compliance is the responsibility of the governing body of an organization. How exactly this body decides to manage compliance is largely up to them, but it is important that they implement specific policies regarding following regulations. Furthermore, while this body may choose to assign compliance responsibilities to a compliance officer or team, every employee of a healthcare business has a role to play in maintaining compliance. Healthcare practitioners need to have an in-depth understanding of the specific standards that impact their work and how they handle patient information. Additionally, it is critical for a business to have an anonymous reporting system in place, so that employees feel comfortable raising any questions or concerns they may have.

Employing a designated compliance officer is undoubtedly the most common method adopted by healthcare businesses. These officers should be adequately trained and have a direct relationship with members of the governing body. This way, compliance issues can be dealt with quickly and effectively, and the healthcare practice can modify its existing policies if necessary. It is also recommended that a compliance committee should be established to assist with the investigation of issues and the implementation of training programs.

Role of a healthcare compliance officer in private practices

Working as a healthcare compliance officer involves various responsibilities pertaining to adherence to regulations and quality management. Although the specific work completed by a compliance officer will depend on the services offered by your practice, some of their key responsibilities include:

Business paperwork: Organizing and storing business paperwork is often a task that is either forgotten or swept under the rock. However, in legal situations or employment issues, it is extremely necessary for these documents to be organized and accessible. As a compliance officer, you should ensure that paperwork, including insurance policies, employment contracts, property agreements, and crisis management plans are all completed and accessible.
Digital security: Advancements in healthcare technology have led to the increased development of software for private practices. If you choose to implement these systems into your business, it is important to establish security protocols so that digital information is protected. Any system that you use should be HIPAA-compliant and enforce high-quality encryption. Before implementing any software, compliance officers should check the security features to ensure they are adequate and provide a training program so practitioners know how to appropriately handle online information.
Documentation: Clinical documentation is an essential aspect of working as a healthcare practitioner that often requires handling sensitive information. As a compliance officer, you need to make sure that clinical documentation is completed accurately and in a timely manner. Additionally, once clinical notes have been written, they need to be stored in a safe, HIPAA-compliant manner.
Training programs: The most common compliance breaches in the healthcare industry are accidental, including failing to properly encrypt data stored on mobile phones and having personal computers stolen. Further, it is usually the case that practitioners weren’t aware of the breaches they were making, which means that these mistakes are highly avoidable. It is in the best interest of a healthcare practice to routinely implement compliance training programs. These will minimize the risk of accidental breaches and ensure that practitioners are kept up to date with any changes in regulations.
Managing and investigating complaints: One of the trickiest aspects of working as a compliance officer is encouraging employees to raise any concerns or breaches that they are aware of. It is extremely important to have an anonymous reporting system, and to protect the individuals who raised any concerns. When you are made aware of an issue, it is your responsibility to effectively manage it and modify the current policies, if necessary.

The necessity and benefits of a compliance officer for healthcare businesses

You may be thinking that the policies already in place at your healthcare business are effective enough that there is no need for a compliance officer. However, it is common knowledge that compliance rules and regulations are becoming increasingly complicated as a result of efforts to cut down on security breaches. As such, it has never been more important than right now to employ a knowledgeable compliance officer. Some of the various benefits you will experience with a compliance officer include:

The ability to implement necessary policy changes quickly and efficiently.
Minimizing the risk of accidental breaches and non-compliance.
Ensuring that any new systems or software adhere to compliance regulations.
Improving the general culture within your practice, and ensuring every employee is accountable for their actions.
Encouraging efficient management and investigation of compliance issues.

Take home message

As the standards dictated by medical compliance become increasingly complicated, it is important to implement new tools and resources to ensure that your business remains compliant. Many practices have begun to install medical compliance software that will help ensure your current policies are up to scratch. If you are interested in utilizing these tools, we recommend having a look at Carepatron. Carepatron is a HIPAA-compliant, integrated platform that offers resources designed to elevate your compliance and minimize any risk of breaches. With compliance software, you can feel comfortable that clinical records are generated, stored, and accessed with great care, ensuring both your patients and practitioners are protected.